Matthew Colman McCluskey, RADT-1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1514310723 Issued in CA

Practice address

2844 Coloma St
Placerville, CA 95667-4406

Phone

(530) 333-9460

NPI assigned

Sep 28, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1043099971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 BELL RD # 214",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032540",
            "telephone_number": "916-208-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2844 COLOMA ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674406",
            "telephone_number": "530-333-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUSKEY",
        "first_name": "MATTHEW",
        "middle_name": "COLMAN",
        "credential": "RADT-1",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1514310723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Mazariegos
• Hilary Mazzone
• Kathleen Mary McArtin, LMFT
• Tamba Maurice McCarthy, PSYCH TECH
• Colleen P McCartin, IMF
• Delandy McConnell, D.O.
• Melissa R McCord
• Natalia McCormack
• Katherine Leigh McCormick
• Cari Renee McCracken, CADC - CAS

• Addiction (Substance Use Disorder) Counselor in Placerville, CA
• Providers in Placerville, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.